Provider Demographics
NPI:1992947287
Name:HARVEY, MARK WESLEY (APRN-NP)
Entity type:Individual
Prefix:MR
First Name:MARK
Middle Name:WESLEY
Last Name:HARVEY
Suffix:
Gender:M
Credentials:APRN-NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:705 ORLEANS DR
Mailing Address - Street 2:
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NE
Mailing Address - Zip Code:68803-3409
Mailing Address - Country:US
Mailing Address - Phone:402-845-9203
Mailing Address - Fax:
Practice Address - Street 1:705 ORLEANS DR
Practice Address - Street 2:
Practice Address - City:GRAND ISLAND
Practice Address - State:NE
Practice Address - Zip Code:68803-3409
Practice Address - Country:US
Practice Address - Phone:308-398-6063
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-01
Last Update Date:2012-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE111016363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily